SPECIAL ARTICLE
The Influence of Community Access to Child Health
(CATCH) Program on Community Pediatrics
AUTHORS: Neelkamal S. Soares, MD,a Wendy L. Hobson,
MD, MSPH,b Holly Ruch-Ross, ScD,c Maureen Finneran,
MSW,d Denia A. Varrasso, MD,d and David Keller, MDe
aJanet
Weis Children’s Hospital, Geisinger Medical Center,
Lewisburg, Pennsylvania; bUniversity of Utah School of Medicine,
Salt Lake City, Utah; cIndependent Research and Evaluation
Consultant, Evanston, Illinois; dAmerican Academy of Pediatrics,
Elk Grove Village, Illinois; and eUniversity of Colorado School of
Medicine, Aurora, Colorado
KEY WORDS
community, pediatrics, evaluation
ABBREVIATIONS
AAP—American Academy of Pediatrics
CATCH—Community Access to Child Health
SCHIP—State Children’s Health Insurance Program
Dr Soares conceptualized and designed the study and drafted
the initial manuscript; Dr Hobson designed the study and
reviewed and revised the manuscript; Dr Ruch-Ross was
involved in the initial design and implementation of the
evaluation plan and data system, conducted the data analysis,
and revised the manuscript; Ms Finneran provided data on the
CATCH Program and reviewed and revised the manuscript; Dr
Varrasso was involved in the initial design and implementation
of the evaluation plan and reviewed the manuscript; Dr Keller
was involved in the initial design and implementation of the
evaluation plan, and reviewed and revised the manuscript; and
all authors accepted the final manuscript as submitted and
revised and approved the final manuscript as submitted.
www.pediatrics.org/cgi/doi/10.1542/peds.2013-1471
doi:10.1542/peds.2013-1471
Accepted for publication Oct 25, 2013
Address correspondence to Neelkamal S. Soares, MD, 120 Hamm
Dr, Suite 2, Lewisburg, PA 17837. E-mail: [email protected]
abstract
The CATCH (Community Access to Child Health) Program, which supports
pediatricians who engage with the community to improve child health,
increase access to health care, and promote advocacy through small seed
grants, was last evaluated in 1998. The objective was to describe the characteristics of CATCH grant recipients and projects and assess the community impact of funded projects. Prospective data was collected from CATCH
applications (grantee characteristics, topic area and target population for
projects funded from 2006–2012) and post-project 2-year follow-up survey
(project outcomes, sustainability, and impact for projects funded from
2008 through 2010). From 2006 through 2012, the CATCH Program
awarded 401 projects to grantees working mostly in general pediatrics.
Eighty-five percent of projects targeted children covered by Medicaid,
33% targeted uninsured children, and 75% involved a Latino population.
Main topic areas addressed were nutrition, access to health care, and
medical home. Sixty-nine percent of grantees from 2008 to 2010
responded to the follow-up survey. Ninety percent reported completing
their projects, and 86% of those projects continued to exist in some form.
Grantees reported the development of community partnerships (77%)
and enhanced recognition of child health issues in the community (73%)
as the most frequent changes due to the projects. The CATCH Program
funds community-based projects led by pediatricians that address the
medical home and access to care. A majority of these projects and
community partnerships are sustained beyond their original CATCH funding and, in many cases, are leveraged into additional financial or other
community support. Pediatrics 2014;133:1–8
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
Copyright © 2014 by the American Academy of Pediatrics
FINANCIAL DISCLOSURE: The authors have indicated they have
no financial relationships relevant to this article to disclose.
FUNDING: No external funding.
POTENTIAL CONFLICT OF INTEREST: The authors have indicated
they have no potential conflicts of interest to disclose.
PEDIATRICS Volume 133, Number 1, January 2014
1
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The Community Access to Child Health
(CATCH) program supports pediatricians
who engage with their communities to
increase children’s access to medical
homes or specific health services not
otherwise available, to improve overall
child health at the community level,
and to advocate for health equity within
their communities. The program encourages community-based pediatricians to
take on a leadership role on the project
and to include broad-based community
partnerships as well as plans for achievable sustainability beyond the grant period.
Over its 20-year history, CATCH has provided funding for 644 grants to practicing
pediatricians. CATCH grants are small,
used as seed money for planning a program or starting a community project to
increase children’s access to health services in the community.1 The CATCH program began so that pediatricians could
solve local issues using collaboration
with community partners. CATCH projects often serve as a leading indicator
for emerging issues of concern within
child health and provide an opportunity
for pediatricians to address children’s
health needs through community-based
solutions tested on a small scale. The
program focuses on children who experience health inequities or who are uninsured or who are insured but cannot
always obtain the services they need.
In the late 1960s, Philip J. Porter, MD,
had a vision of creating the Healthy
Children Program. With funding from
the Robert Wood Johnson Foundation,
the program was formally established
in 1983 to make health care services
universally accessible to children who
need them and to leverage existing
human and fiscal resources in the
community. Under the vision of Julius
B. Richmond, MD, and with the financial support from the American
Academy of Pediatrics (AAP), the
Healthy Children program merged
with the AAPAccess to Care Initiative in
2
the late 1980s. By 1990, the AAP
launched the “One Pediatrician Can
Make a Difference for America’s
Children” message with a greater
emphasis on local pediatricians and
community leaders joining together
to devise comprehensive, communitybased solutions to community-defined
problems. With continued Robert Wood
Johnson Foundation funding in 1991, the
program emerged as the CATCH program with F. Edwards Rushton, MD, as
its first director. In 1995, under Thomas
F. Tonniges, MD, there was greater integration of the medical home component in the CATCH program. For a
detailed history of the CATCH Program,
please refer to Hutchins et al 1999.2
Today the CATCH Program is administered by the AAP Division of
Community-based Initiatives within
the Department of Community, Chapter
and State Affairs, reflecting the importance that the AAP attributes to the promotion of community engagement by its
members. To support pediatricians engaged in CATCH activities, the AAP has
established the CATCH Network, a trained
group of volunteer AAP chapter and district members, many of whom are current and past CATCH grantees. An
important function of the network is to
provide training and technical assistance
for thekeyskillsnecessarytodevelopand
implement a community-based child
health initiative. This can include guidance on how to conduct a needs assessment, community asset mapping,
developing resources, motivating colleagues, community coalition building,
and program evaluation.1 Information
about CATCH grants is available to the
public via the Community Pediatrics
Grants Database.3 The database serves
as a resource for prospective grantees
for ideas and for funded grantees for peer
consultation. There are 2 types of grants
available to practicing pediatricians:
Planning and Implementation. Planning grants provide funding for the
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planning phase of a communitybased project, and Implementation
grants provide funding for the initial
pilot phase of a project. Following
are examples illustrating each of the
types of grants.
2008 CATCH Planning Grant
Children’s Outreach: Targeted Community Needs Assessment Turner
Courts Service Area
Leann Kridelbaugh MD, FAAP, Dallas,
Texas
Award: $7350
This project partnered the lead pediatrician with community leaders and
residents in a medically underserved
area to develop and administer a community pediatric health questionnaire.
This survey, translated into Spanish, was
composed of 42 items to measure a variety of issues relevant to pediatric
health and given to .100 parents, which
helped identify barriers to care and
pressing health issues in the community. It indicated a high rate of
asthma (37%) in the community’s
pediatric population and a high rate
of low-acuity emergency department
utilization. This culminated in an
asthma outreach and education effort, raised neighborhood residents’
awareness of children’s health issues, and enhanced the recognition
of the community’s health care and
social service resources through the
provision of a comprehensive pediatric community resources list. This
list was also made available to community organizations and facilitated improved children’s access to needed
services. Since the grant has ended,
there has been a renewed focus on
asthma in the community, and a community stakeholders group has been
formed to continue to address children’s
health issues.
SPECIAL ARTICLE
2009 CATCH Implementation
Grant
AmeriCorps Workers as Medicaid/
State Children’s Health Insurance
Program Case Managers
Carole Stipelman MD, MPH, FAAP,
Salt Lake City, Utah
Award: $11 450
At the Community Health Center clinics
in Salt Lake County, .95% of the pediatric patients are Latino, 25% of whom
are uninsured. Of the uninsured children, 80% are eligible for Medicaid or
State Children’s Health Insurance Program (SCHIP) but have not successfully
completed the application process.
Through a CATCH Implementation
grant, a pilot program was developed to
train AmeriCorps members at a community health center to work with families to obtain Medicaid/SCHIP coverage.
In a 4-month period, 74% of children
from the clinic where case management
was provided were enrolled, compared
with 26% from the clinic where no case
management was provided.
The pilot also found that children who
gained coverage were more likely to
use preventive care in the following 6
months despite availability of slidingscale fees for uninsured. As a result of
the grant, communication was improved
among the Department of Health, the
Department of Workforce Services,
other community-based agencies, and
the clinic. Findings from the CATCH
grant were used to apply and led to the
receipt of a Children’s Health Insurance
Reauthorization Act (CHIPRA) grant to
expand the concept to 8 Community
Health Center clinics in Utah, and fulltime clinic employees were used to
perform case management. Since that
project, a coalition of the Association
for Utah Community Health, United Way
2-1-1, and Utah Health Policy Project
has continued to develop the work
initiated by the CATCH grant using 25
AmeriCorps members and training many
other nonvolunteer staff in the pilot
model.
In 1996, the Women’s and Children’s
Health Policy Center at Johns Hopkins
School of Public Health conducted an
independent evaluation of the first 7
years of the CATCH program. Through
case studies, oral history, surveys, and
key informant interviews, the evaluation
showed the potential of the CATCH program to affect the health of children and
communities through creative collaborations.4 In the ensuing years, the CATCH
program has grown in size and sophistication and has diversified its funding,
leading to topic and population-specific
funding for projects that have focused
on oral health, immunizations, obesity/
overweight prevention, reducing the impact of secondhand smoke, and American
Indian/Alaska Native children. In 2006, the
CATCH program instituted a systematic
effort to collect information regarding the
grantees, their projects and the impact of
funding and technical support on the
project, the project’s target population
and career trajectory of the grantee. This
report summarizes the results of that
effort.
OBJECTIVE
To describe the characteristics of the
recipients of CATCH grant funds awarded from 2006 to 2012 and assess the
community impact for a subset of
grants awarded from 2008 to 2010.
METHODS
CATCH proposals are solicited twice
each year from pediatricians practicing
in the United States. The proposals are
reviewed by at least 3 members of the
CATCH network at the state and regional
levels and scored on selected criteria to
establish funding priority. Grants are
awarded on the basis of ranking and the
availability of funds. CATCH funds are
budgeted to be spent within 6 months
PEDIATRICS Volume 133, Number 1, January 2014
of award, although up to two 6-month
extensions may be granted at the request
of the grantee. CATCH routinely collects
information about the pediatrician applicant and the project, including community
demographics and goals. Two years after
grant completion, information is collected
about the project, the pediatrician’s involvement in the project, and sustainability.
Applicant Characteristics
Starting in 2006, applicants applied
through a Web-based application that
facilitated the collection of data regarding the applicant, the applicants’
practice site, the community and population to be targeted, and the nature
of the proposed intervention.
Deidentified application data for successful applicants were used to create
descriptive statistics for the successful
applicants from 2006 to 2012.
Postgrant Assessment
From 2006 to 2008, the CATCH leadership
and staff developed a Grantee Follow-Up
Survey in consultation with research
and evaluation experts within the AAP
(see Supplemental Information). The
survey inquires about the project’s
outcome, the pediatrician’s ongoing
role in both this project and the field of
community pediatrics, and the impact
of the project on child health in the
community. Follow-up questions were
derived from 2 primary sources. Most
demographic and pediatrician-specific
questions were drawn from the Periodic Survey of the AAP. Most questions
specific to the goals of the CATCH program were adapted from the 2004
evaluation plan developed by Cynthia
Minkovitz and Holly Grason of Johns
Hopkins University Bloomberg School
of Public Health.5
To supplement forced choice semiquantitative items, respondents were
afforded the opportunity to provide
feedback or explanation through
3
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qualitative responses to summative
questions. All grantees receiving
awards from 2008 on were invited to
complete the Grantee Follow-Up Survey
2 years after the completion of their
projects. Becauseof thetimelag between
the grant award and follow-up survey,
postgrant assessment data were only
available for grants funded from 2008 to
2010 at the time of this analysis (Fig 1).
Follow-up data are not available for
grants funded before 2008 (approximately one-third of those in the 2006–
2012 time frame), but will be collected
for the 2011 and 2012 cohorts (∼22% of
grants in the time frame) and additional
cohorts going forward at the appropriate 2-year interval.
Data Analysis
SPSS18.0 (2009, PASW Statistics for
Windows, Version 18.0. Chicago, IL: SPSS
Inc) was used to create descriptive
statistics of applicant characteristics
and postgrant assessments. Information
onprimaryfocusandtopicsofgrantswas
collapsed into categories using qualitative analytic techniques. Responses
were coded and grouped into themes
independently by 2 investigators (NSS
andWLH),anddiscrepancieswereresolved
FIGURE 1
CATCH applicants and grantees, 2006 through 2012. aFollow-up survey fielded ∼2 years after funding
notification.
via investigator consensus. Thematic categorieswereusedtocharacterizethetypes
of grants awarded and topics important to
pediatricians who applied to CATCH.
Figure 2 illustrates the distribution of
grants awarded across all AAP chapters.
The study was exempted from formal
informed consent by the Institutional
Review Board of the AAP.
Description of CATCH Grantees and
Projects
RESULTS
Over a 7-year period (2006–2012), the
CATCH Program funded 401 projects of
731 applications (55%) with an average
award amount of $10 213. Grants were
awarded throughout the United States.
FIGURE 2
CATCH grants 2006 through 2012.
4
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Eighty-seven percent of grantees reported
obtaining technical assistance for their
projects from the CATCH network,
mostly from chapter facilitators (62%)
and CATCH staff (36%). The nature of technical assistance obtained was varied,
with proposal preparation/grant writing (63%) and information/materials
SPECIAL ARTICLE
(44%) most frequently reported. Most
grantees (80%) worked full-time in
a variety of clinical settings, with 76%
spending more than half of their time in
general pediatrics (Table 1).
The projects were conducted in a broad
range of communities and settings, with
47% in urban, inner-city communities
and 41% in rural communities. More
than a quarter (26%) of projects were
TABLE 1 Characteristics of CATCH Grantees
at Time of Application, 2006–2012
(N = 401)
Characteristics
Grantee characteristics
Employment status
Employed full-time
Not employed full-time
Primary employment setting
Solo or 2 physician practice
3–10 physician pediatric
practice
.10 pediatrician practice
Multispecialty group practice
Medical school or parent
university
Nonprofit community
health center
Nongovernment hospital or
clinic
Government clinic
Other
Time in general pediatrics
100% of time
50%–99% of time
,50% of time
No time in general
pediatrics
Project characteristics
Communitya
Urban, inner city
Urban, not inner city
Suburban
Rural
Other
Project setting is academic
Primary setting
Clinic
Community-based
organization
Hospital
Multispecialty clinic
Preschool/day-care
center/Head Start
Private practice
Public health department
School
Other
a
n
%
322
79
80.3
19.7
28
66
7.0
16.5
14
25
70
3.5
6.2
17.5
77
19.2
59
14.7
25
37
6.2
9.2
219
70
68
20
58.1
18.6
18.0
5.3
187
142
101
163
26
97
46.6
35.4
25.2
40.6
6.5
24.4
107
86
26.9
21.6
30
13
6
7.5
3.3
1.5
20
9
60
67
5.0
2.3
15.1
16.8
Multiple responses permitted.
conducted in health clinic settings, 21%
in community-based organizations and
15% in schools. Collectively, the projects
looked to address community and/or
system issues across the entire age
and developmental spectrum of childhood and adolescence. A majority of the
projects (85%) focused on children
covered by Medicaid and one-third
(33%) on uninsured children. Most
projects targeted multiple ethnic groups,
with the highest proportion (75%)
reporting a Latino population as a primary target population (Table 2).
Forty-five project topic foci were reported
by grantees. These foci were grouped into
8 thematic categories (Table 3). Although
themes varied slightly year to year, nutrition, medical home, and access to care
were the most frequently reported areas
of focus over the 7 years included in this
review.
Grantee Follow-Up Survey Data
From 2008 to 2010, 187 grants were
funded. After exclusion of those who
declined their grants, those who had
reported that their grants were not
completed as of the 2012 survey date,
and those for whom no current contact
information was available, 157 grantees
were electronically sent the Grantee
Follow-Up Survey, ∼2 years after their
grants were awarded. Sixty-nine percent of grantees (n = 109) responded to
the follow-up surveys. Ninety percent
(98) reported that they had completed
their projects, and of those, 66% (62)
reported that they remained involved
with the project. Of those who had
completed their projects, 86% (83) indicated that the project continued to
exist, in the original form, partial form,
expansion into a larger project, or by
being absorbed into a larger organization or intervention. Post-CATCH funding of projects came from a variety of
sources (Table 4). Twenty-nine percent of
grantees reported leveraging additional
funding for their projects. Partnerships
PEDIATRICS Volume 133, Number 1, January 2014
TABLE 2 Target Populations of CATCH
Grants, 2006–2012 (N = 401)
Population
Health care coveragea
Indian Health Service
Medicaid/SCHIP
Private insurance
Uninsured
Other
Race/ethnicityb
Asian/Pacific Islander
Black
Hispanic
Native American
White, non-Hispanic
Other
Developmental stage categoryb
Infant and toddler (birth–2 y)
Preschool age (3–5 y)
School age (6–10 y)
Adolescent (11–21 y)
Other
Special populations targetedc
Children in foster care
Children living in poverty
Children or youth with
special needs
Families in crisis
Families in transition
GLBT Youth
Homeless families
Immigrant/Migrant/
Refugee/Undocumented
Minority populations
Native Americans
Pregnant women/New mothers
Underserved children and families
Uninsured/underinsured
children and families
n
%
16
340
32
131
24
4.0
84.8
8.0
32.7
6.0
106
277
302
94
271
48
26.4
69.1
75.3
23.4
67.6
12.0
209
215
225
253
62
52.1
53.6
56.1
63.1
15.5
82
348
177
20.4
86.8
44.1
132
125
19
73
129
32.9
31.2
4.7
18.2
32.2
300
42
99
356
321
74.8
10.5
24.7
88.8
80.0
a
Fifty percent or more of target population in category;
multiple response permitted.
b Primary target population; multiple response permitted.
c Multiple responses permitted.
with diverse community organizations
were developed during the projects, and
97% (91) of respondents reported that at
least some of those partnerships were
sustained. Sixty-four percent (59) of grantees reported forming new partnerships
since CATCH funding had ended. At the time
of the follow-up, a majority (51.5%) of
respondents reported active partnerships
with local public health service agencies.
Other frequently reported active partnerships were with schools/education groups
(46.4%), parents/families (44.3%), grassroots organizations (43.3%), and hospitals
(42.3%). Although we know the types of
5
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TABLE 3 Primary Topic of CATCH Grants by Year, 2006–2012 (N = 419)
Topic
Grant Year
2006
Access to care
Adolescent health
CSHCN/disabilities
Community advocacy, health promotion
Health disparties/underserved
Medical home/general pediatrics
Mental health
Nutrition
Other
2007
2008
2009
2010
2011
2012
2006–2012
n
%
n
%
n
%
n
%
n
%
n
%
n
%
n
%
10
3
5
8
6
10
6
15
1
15.6
4.7
7.8
12.5
9.4
15.6
9.4
23.4
1.6
7
5
5
3
6
12
2
22
1
11.1
7.9
7.9
4.8
9.5
19.0
3.2
34.9
1.6
6
7
9
7
11
9
6
12
1
8.8
10.3
13.2
10.3
16.2
13.2
8.8
17.6
1.5
9
5
6
5
7
10
4
19
1
13.6
7.6
9.1
7.6
10.6
15.2
6.1
28.8
1.5
5
6
4
5
4
17
3
9
0
9.4
11.3
7.5
9.4
7.5
32.1
5.7
17.0
0.0
4
3
7
0
7
7
5
8
0
9.8
7.3
17.1
0.0
17.1
17.1
12.2
19.5
0.0
8
2
9
2
9
13
1
18
2
12.5
3.1
14.1
3.1
14.1
20.3
1.6
28.
3.1
49
31
45
30
50
78
27
103
6
11.7
7.4
10.7
7.2
11.9
18.6
6.4
24.6
1.4
CSHCN, children with special health care needs.
organizations partnered with, we do not
have information on the nature of the
partnerships.
Grantees were asked to indicate changes
that had occurred in their communities
as a result of their CATCH projects.
Respondents reported a wide range of
community changes, most frequently including the development of community
partnerships (77%), enhanced recognition of child health issues in the community (73%), and expanded pediatrician
involvement in community-based programs (72%) (Table 4). Additionally,
respondents reported that their CATCHfunded projects helped to enhance the
visibility of pediatricians in their communities (64%).
Three grantees reported that they
would be unable to complete their
projects. One reported lack of community interest in the project, and another reported being limited by time
constraints and “extensive reporting
requirements.” The third grantee who
did not expect to complete the project
had left her position and was unable to
identify another provider to take it
over.
DISCUSSION
Pediatricians in the 21st century have
been called on to improve the health of
all children in a world of changing demographics, inequitable distribution of
6
health care resources and an increasing
number of children growing up in poverty.6 For the past 20 years, AAP CATCH
grants have helped pediatricians engage with communities to improve child
health. The grantees funded from 2006
to 2012 proposed projects that addressed
the needs of infants, children, and adolescents throughout the country, focusing
on families whose children were part of
Medicaid programs and those who were
not able to access insurance. Grantees
were engaged in the practice of community pediatrics,7 working with other professionals, community agencies, and
parents to achieve optimal access to appropriate, high-value of services for all
children.8 Only 26% of applicants were in
academic practice, indicating that the
program has successfully supported
practicing pediatricians, outside of academic health centers, in community engagement. The grantees described their
work as supportive of the medical home
model9 in which pediatricians deliver
family-centered comprehensive care to all
children and youth, addressing the “millennial morbidities”10 of children’s health.
Over the past decade, pediatricians
have become less likely to engage in the
kind of community activities supported
by the CATCH program. According to
a survey of practicing fellows of the AAP,
pediatrician involvement in community
child health activities dropped from
45.1% in 2004 to 39.9% in 2010. Over that
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same period, the percentage of pediatricians receiving payment for community child health activities fell from 20.5%
to 14.2%.11 CATCH attempts to encourage
pediatricians, through relatively small
starter grants of #$12 000, to engage
in a greater role in community health.
CATCH or other community engagement
programs may not be sufficient, however, to overcome the economic reality
of the way in which pediatricians are
compensated for their professional efforts.
More research is needed to understand
the reasons for the change in pediatricians’
involvement in community child health and
the factors that facilitate or hinder that
participation.
The CATCH program was designed to
help pediatricians create sustainable
partnerships that have an impact on the
communities they serve. More than half
of respondents reported partnering
with public health agencies and more
than a third with government health
agencies, suggesting the possibility of
an effect on policy, population health,
and children’s health and health care.
Because of the small size and diverse
foci of CATCH projects, child health
outcome measures with statistical rigor
are seldom available for study. However,
reported community effects and sustainability of these projects are encouraging.
Eight-six percent of completed projects
continued to exist after the end of funding,
and partnerships were sustained and
SPECIAL ARTICLE
expanded, similar to the sustainability
seen in the Maternal and Child Health
Bureau’s Healthy Tomorrows program.12
Pediatricians, often using in-kind support,
were able to collaborate with partnering
organizations to continue these projects.
Sustained community engagement allows
pediatricians to address important child
health issues such as poverty, early childhood brain development, epigenetics,
quality and access, highlighted by the
AAP in the Agenda for Children13 and
the Vision of Pediatrics 2020.14 Priority
areas such as care of Children with
Special Healthcare Needs and child
nutrition continue to be among those
most consistently receiving CATCH
funding. Over time, these projects have
the potential to influence the health of
the communities they serve.
Because this is a descriptive study,
relying on self-report for the initial
assessment and the follow-up survey,
the result must be interpreted with
caution. There is no control or comparison group, so changes in both the
degree of pediatric engagement and in
community outcome cannot be solely
attributed to the CATCH program. There
is a risk of response bias and recall
bias in grantee survey data, and there
was no mechanism to corroborate
grantee reporting with actual outcomes in communities. These data
should be seen as a summary of the
current state of the program, and future directions may include a closer
study of a subset of grantees in any
given year or a large-scale survey of all
members of the CATCH Network. Inclusion of final reports from grantees
after completion of their projects in
analyses may yield qualitative data
revealing additional themes of interest, but those data were not available at the time of this study. CATCH is
a philosophy, a process, and a program
and is an evolving set of concepts
based on program goals that have been
additive and evolving.15 The program
TABLE 4 CATCH Grantee Follow-Up, Completed Projects Initially Funded 2008–2010 (N = 98)
What is your current involvement with your CATCH-funded project?
Currently involved
Involvement ended within the past year
Involvement ended .1 year ago
What is the current status of your CATCH-funded project?
Still exists in some form
No longer exists
Don’t know
How is your CATCH project funded now?a
Community fundraising
Healthy Tomorrows
Local business/corporate funding
Local foundation
National foundation
Other federal funding
Other government funding
Sponsoring organization
United Way
Other
Don’t know
Has your CATCH-funded project helped to leverage additional funding?
Yes
No
Don’t know
Have the community partnerships you established during your grant been sustained
since project funding ended?
Most
Some
Almost none
Don’t know
Have you established new community partnerships related to your CATCH project since
the end of your CATCH funding?
Yes
No
With which types of organizations do you have active community partnerships?
Business organizations
Faith-based groups
Government health agencies
Grassroots organization
Hospitals
Local businesses
Local public health service agencies
Nongovernmental health agencies
Parents or families
Schools or education groups
Service clubs
Youth groups
Other
Looking back, which of the following have occurred in your community as a result of your
CATCH-funded project?
Advanced the field of community pediatrics
Developed new partnerships between pediatricians and other health/social service
professionals
Enabled community to identify child health problems
Enhanced advocacy efforts in the community
Enhanced community capacity to impact child health problems
Enhanced cultural competency of services provided in community
Enhanced recognition of child health issues in the community
Enhanced relationship between academic community and pediatricians in practice in
the community
Enhanced relationship between pediatrician and public officials and policy makers
Enhanced visibility of pediatricians in community
Expanded pediatrician involvement in community-based programs
PEDIATRICS Volume 133, Number 1, January 2014
n
%
62
24
8
66.0
25.5
8.5
83
11
2
86.5
11.5
2.1
15
1
7
17
2
7
15
38
3
26
1
18.1
1.2
8.4
20.5
2.4
8.4
18.1
45.8
3.6
31.3
1.2
27
40
25
29.3
43.5
27.2
68
23
2
1
72.3
24.5
2.1
1.1
59
33
64.1
35.9
11
16
34
42
41
17
50
28
43
45
11
13
24
11.3
16.5
35.1
43.3
42.3
17.5
51.5
28.9
44.3
46.4
11.3
13.4
24.7
53
75
54.6
77.3
60
66
63
42
71
35
61.9
68.0
64.9
43.3
73.2
36.1
42
62
70
43.3
63.9
72.2
7
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CONCLUSIONS
TABLE 4 Continued
Improved access to a medical home for children
Improved access to services for children
a
b
n
%
54
63
55.7
64.9
Multiple responses permitted.
Proportion responding yes.
continues to explore ways to refine the
evaluative component of the program,
and future studies may reflect these
methodologies.
CATCH was originally conceived as 1 of the
3 prongs of the AAP’s Access to
Care Initiative related to establishing
community-based programs and the
belief that pediatricians are not too busy
to become involved in community work
because they benefit directly from such
activity and they are particularly well
suited to initiate leadership in the
community.2 As the US health care
system evolves towardperformancebased management and patientcentered care, as envisioned in the Affordable Care Act,16 this concept has
increasing relevance because primary
care practitioners will be held accountable for population outcomes.
Those receiving CATCH grants report
being able to practice population
health at the community level and assume leadership roles in overcoming
barriers to implementing system
changes in communities to improve
child health. The core of CATCH is the
family-centered medical home, which
is considered the foundation of a primary-care-driven integrated delivery
system that will anchor an Accountable
Care Organization.17 CATCH may be able
to serve as an incubator for the practitioner of the future as health care
moves toward this accountable care
model.
The CATCH Program funds communitybased projects led by community
pediatricians that address the medical home and access to care. A substantial majority of these projects and
the community partnerships CATCH
seeks to foster are sustained beyond
their original CATCH funding and, in
many cases, are leveraged into additional financial or other community
support.
ACKNOWLEDGMENTS
We thank the CATCH staff and District
CATCH facilitators for their guidance,
as well as Dr Marsha Raulerson and
Dr Paul Chung for input on the content
of this article. The CATCH program is
a national program of the AAP supported by Pfizer, Inc., the Walmart Foundation, and individual donations
through the AAP Friends of Children
Fund.
REFERENCES
1. American Academy of Pediatrics Community
Access to Child Health (CATCH). Available at:
http://www2.aap.org/catch. Accessed on
June 21, 2012
2. Hutchins VL, Grason H, Aliza B, Minkovitz C,
Guyer B. Community Access to Child Health
(CATCH) in the historical context of community pediatrics. Pediatrics. 1999;103(6 pt
3):1373–1383
3. American Academy of Pediatrics Community
Pediatrics Grants Database. Available at:
http://www2.aap.org/commpeds/default.
cfm. Accessed on May 3, 2013
4. Minkovitz C, Grason H, Aliza B, Hutchins V,
Rojas-Smith L, Guyer B. Evaluation of the
Community Access to Child Health Program. Pediatrics. 1999;103(6 pt 3):1384–
1393
5. Minkovitz C, Grason H. CATCH Program
Evaluation Report. Unpublished report,
October 2004
6. Palfrey JS, Tonniges TF, Green M, Richmond J.
Introduction: addressing the millennial morbidity—the context of community pediatrics.
Pediatrics. 2005;115(suppl 4):1121–1123
8
7. American Academy of Pediatrics Committee on Community Health Services. The
pediatrician’s role in community pediatrics.
Pediatrics. 2005;115(4):1092–1094
8. Bergman DA. Thriving in the 21st century:
outcome assessment, practice parameters,
and accountability. Pediatrics. 1995;96(4 pt
2):831–835
9. Medical Home Initiatives for Children With
Special Needs Project Advisory Committee. The
medical home. Pediatrics. 2002;110(1)184–186
10. Palfrey JS. Richmond JB Health services:
past, present, and future. In: Cosby AG,
Greenberg RE, Southward LH, Weitzman M,
eds. About Children. Elk Grove Village, IL:
American Academy of Pediatrics; 2005
11. Minkovitz C, Grason H, Solomon B, Kuo A,
O’Connor K. Pediatricians’ involvement in
community child health: rhetoric or reality?
Presented at the Pediatric Academic Societies Annual Meeting. Platform Session:
General Pediatrics and Obesity; May 1,
2011; Denver, CO
12. Ruch-Ross H, Keller DM, Miller N, Bassewitz
J, Melinkovich P. Evaluation of community-
SOARES et al
Downloaded from by guest on June 18, 2017
13.
14.
15.
16.
17.
based health projects: the healthy tomorrows experience. Pediatrics. 2008;122(3).
Available at: www.pediatrics.org/cgi/content/full/122/3/e564
American Academy of Pediatrics Agenda for
Children. Available at: http://www.aap.org/enus/about-the-aap/aap-facts/AAP-Agenda-for-Children-Strategic-Plan/Pages/AAP-Agendafor-Children-Strategic-Plan.aspx. Accessed
July 18, 2013
Starmer AJ, Duby JC, Slaw KM, Edwards A,
Leslie LK; Members of Vision of Pediatrics
2020 Task Force. Pediatrics in the year 2020
and beyond: preparing for plausible
futures. Pediatrics. 2010;126(5):971–981
Tonniges T. Reflection from the Department of
Community Pediatrics. Pediatrics. 1999;103:1430
Patient protection and Affordable Care Act.
Available at: http://www.gpo.gov/fdsys/pkg/
PLAW-111publ148/html/PLAW-111publ148.
htm. Accessed February 2, 2013
Accountable Care Organization Workgroup.
Accountable care organizations (ACOs) and
pediatricians: evaluation and engagement.
AAP News. 2011;32:1
The Influence of Community Access to Child Health (CATCH) Program on
Community Pediatrics
Neelkamal S. Soares, Wendy L. Hobson, Holly Ruch-Ross, Maureen Finneran, Denia
A. Varrasso and David Keller
Pediatrics; originally published online December 9, 2013;
DOI: 10.1542/peds.2013-1471
Updated Information &
Services
including high resolution figures, can be found at:
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PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly
publication, it has been published continuously since 1948. PEDIATRICS is owned, published,
and trademarked by the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk
Grove Village, Illinois, 60007. Copyright © 2013 by the American Academy of Pediatrics. All
rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275.
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The Influence of Community Access to Child Health (CATCH) Program on
Community Pediatrics
Neelkamal S. Soares, Wendy L. Hobson, Holly Ruch-Ross, Maureen Finneran, Denia
A. Varrasso and David Keller
Pediatrics; originally published online December 9, 2013;
DOI: 10.1542/peds.2013-1471
The online version of this article, along with updated information and services, is
located on the World Wide Web at:
/content/early/2013/12/03/peds.2013-1471
PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly
publication, it has been published continuously since 1948. PEDIATRICS is owned,
published, and trademarked by the American Academy of Pediatrics, 141 Northwest Point
Boulevard, Elk Grove Village, Illinois, 60007. Copyright © 2013 by the American Academy
of Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275.
Downloaded from by guest on June 18, 2017